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OTC Exam > OTC > Flashcards

OTC Flashcards

1
Q

What is Constipation

A

Decrease in bowel motility due to infrequent stool s or difficulty passings stools

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2
Q

Symptoms of Constipation

A

Bloated, Abdominal discomfort/distention

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2
Q

Disease induced (Consitipation)

A

Irritable bowel syndrome, Thyroid dysfunction, Crohn’s disease

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3
Q

Exclusions for self-treatment of Constipation

A
  • Previous appropriate self-care does not resolve symptoms
  • Blood in stool
  • Vomiting
    -Fever
  • Abdominal pain
  • Symptoms persisting >1 week
    -Recent Weight loss
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4
Q

MOA of Bulk-forming Laxatives

A

pull fluid into stool (initial treatment for simple constipation)

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5
Q

3 Drugs of Bulk-forming Laxatives

A

Methylcellulose(Citrucel), Calcium polycarbophil(Fibercon), Psyllium (Metamucil)

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6
Q

The brand name of Methylcellulose

A

Citrucel

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7
Q

The brand name of Calcium polycarbophil

A

Fibercon

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8
Q

The brand name of Psyllium

A

Metamucil

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9
Q

MOA of Emollient Laxatives

A

increases the softening of stool (Agents help to prevent constipation by relieving hard, dry stool)

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10
Q

Adverse effects of Emollient Laxatives

A

Diarrhea, abdominal cramping

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11
Q

Onset action of Emollient Laxatives

A

24-72 hours

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12
Q

1 drug of Emollient Laxatives

A

Docusate sodium

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13
Q

The brand name of Docusate sodium

A

Colace

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14
Q

Dosing of Docusate sodium

A

Children > 6 years: 100mg PO daily
Adults : Up to 100 mg PO tid

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15
Q

MOA of Lubricant Laxatives

A

softens and coats for a “slippery stool”

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16
Q

Adverse Effects of Lubricant Laxatives

A

Abdominal cramping, diarrhea, nausea, vomiting

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17
Q

Onset of action of Lubricant Laxatives

A

8 hours

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18
Q

1 drug of Lubricant Laxatives

A

Mineral oil

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19
Q

Dosing of Mineral Oil

A

Children 6-11 yrs : 10-25mL PO per day
Adults : 15-45 mL PO per day

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20
Q

Recommendation of Mineral Oil

A

for patients who need to avoid straining

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21
Q

Exceptions of Mineral Oil

A
  • Very young patients
  • Advanced age
    -Debilitated patients
  • Not a good recommendation due to lower absorption of fat soluble vitamins
  • Caution : sit upright when taking medications due to risk of aspirating mineral oil into lung (liquid pneumonia)
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22
Q

MOA of Hyperosmotic Laxatives

A

draws water into the colon and provides local irritation to prompt bowel evacuation

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23
Q

Adverse effect of Hyperosmotic Laxatives

A

stomach discomfort, bloating

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24
Q

onset of action

A

varies per product

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25
Q

two drugs of Hyperosmotic Laxatives

A

Glycerin Suppository, Polyethylene Glycol

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26
Q

Brand name of Glycerin suppository

A

Fleet Glycerin suppositroy

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27
Q

dosing of Glycerin suppository

A
  • Children < 6 years : 1 infant suppository rectally 1-2 times per day as needed
  • Adults : 1 suppository rectally 1-2 times per day as needed
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28
Q

Onset of Action of Glycerin suppository

A

within 30 min

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29
Q

Brand name of Polyethylene Glycol

A

Miralax

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30
Q

Dosing of Polyethylene Glycol

A
  • Adults : 17 grams (1 capful) in 4-8 ounces of liquid PO once daily
  • May need to titrate dose
  • should not be used > 1week without consulting physician
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31
Q

onset of action of Polyethylene Glycol

A

2 hours to 4 days

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32
Q

MOA of Stimulant Laxatives

A

increase peristaltic movement throughout the gut by mucosal irritation

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33
Q

Adverse Effects of Stimulant Laxatives

A

abdominal cramping, diarrhea, nausea, vomiting

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34
Q

onset of action of Stimulant Laxatives

A

6-10 hrs

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35
Q

Cautions of Stimulant Laxatives

A

avoid use > 1 week
avoid in patient with constipation due to hard stool

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36
Q

2 drugs of Stimulant Laxatives

A

Bisacodyl (Dulcolax), Sennosides ( Senna)

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37
Q

Brand name of Bisacodyl

A

Ducolax

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38
Q

Brand name of Sennacide

A

Senna

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39
Q

Dosing of Bisacodyl

A

-Children 6-11 yrs : 5-10 mg PO per day (maximum)
-Adults : 5-15 mg PO per day

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40
Q

Dosing of Sennosides

A

Children 6-12 yrs : 8.6 mg PO per day
- Adults: 17.2 mg PO bid
- Max of 4 tablets (34.4mg) PO bid

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41
Q

what’s diarrhea

A

an increase in the patients normal number of bowel movements per day or decrease in consistency of the stool

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42
Q

types of Diarrhea

A

Acute : lasting a few days to a week
Chronic : lasting > three weeks

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43
Q

Goals of Treatment of Diarrhea

A
  • Prevent dehydration
  • Decrease frequency and increase formation of stools
  • Identify cause
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44
Q

Exclusions for self-treatment

A
  • Fever > 101 F
  • Blood present in stool
  • Severe diarrhea with no signs of improvement in 48 hrs
  • Severe dehydration
  • Pregnancy
  • During/following a course of antibiotics
  • immediately following travel from a foreign country
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45
Q

2 drugs of Diarrhea

A

Loperamide, pepto-bismol

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46
Q

2 brand names of Loperamide

A

Imodium, Maalox anti-diarrheal caplets

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47
Q

MOA of Loperamide

A

acts on the opioid receptor to decrease motility allowing for more absorption through the intestines

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48
Q

Dosing of Loperamide

A

Children 6-8 yrs : 1 caplet PO with first loose stool, then 1/2 caplet with each subsequent loose stool
- Max 2 caplets per 24 hrs
Children 9-11 yrs : 1 caplet PO with first loose stool, then 1/2 caplet with each subsequent loose stool
- Max 3 caplets per 24 hrs
Adults > 12 yrs : 2 caplets PO with first loose stool, then 1 caplet with each subsequent loose stool
- Max 4 caplets per 24 hrs

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49
Q

Adverse Effect of Loperamide

A

Constipation, abdominal cramping

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50
Q

Cautions of Loperamide

A
  • counsel patient to stay well hydrated as dehydration is often times more severe than diarrheal alone
51
Q

What is Oral rehydration solutions are the best OTC rehydration products available with a balance of electrolytes?

52
Q

Treatment of Pepto-Bismol

A

Upset stomach, indigestion, diarrhea

53
Q

Another name of Pepto-Bismol

A

Bismuth Subsalicylate

54
Q

Dosing of Pepto-Bismol

A

adults : 1 dose (30 mL) PO every 1/2-1 hour as needed
Max- 8 doses per 24 hrs
Shake well

55
Q

Cautions of Pepto-Bismol

A

Do not use in children < 12 yrs

56
Q

What is Excellent choice for treatment for Pepto-bismol

A

traveler’s Diarrhea (*but, recent travel from a foreign country is an exclusion for self-treatment)

57
Q

What is Heartburn?

A

Burning sensation from stomach up toward neck/throat

58
Q

What is Gastrointestinal reflux disease (GERD)?

A

chronic symptoms of heartburn with possible mucosal damage of the esophagus caused by reflux

59
Q

What is Dyspepsia?

A

consistent or recurrent discomfort located primarily in upper abdomen

60
Q

Goals of Treatment for Heartburn/Dyspepsia

A
  • Alleviate symptoms
  • decrease frequency of recurrence
  • promote healing of mucosal injury
  • prevent complications
61
Q

Exclusions of Self-treatment

A
  • Gastrointestinal bleed
  • Chest pain with pain radiating down to arm, shoulder, neck
  • shortness of breath
  • frequent heartburn for > 3 months without relief from OTC agents
  • Chronic NSAID use (ibuprofen, naproxen)
  • Pregnancy/ lactation
  • Difficult/painful swallowing
  • nighttime heartburn
62
Q

lifestyle changes for Heartburn/Dyspepsia

A
  • lose weight
  • elevate the head of the bed
  • eat smaller meals and avoid meals 3 hrs before bed
  • avoid trigger food which make GERD worse
  • Spicy food, orange and tomato juice, coffee, tea, mints, chocolate, fatty foods, soda/carbonate beverages
  • stop smoking
  • avoid alcohol
  • exercise
63
Q

3 medications of Heartburn/dyspepsia

A

Antacids, Histamine 2 receptor antagonists, Proton pump Inhibitors

64
Q

MOA of Antacids

A

neutralize gastric acid (raises pH), increase lower esophageal sphincter tone

65
Q

Onset of Action of Antacids

65
Q

Duration of Action of Antacids

66
Q

Cautions of Antacids

A
  • Patients should separate antacids from other medications due to possibility of less absorption of other medications
  • Patients with kidney problems should avoid antacids as these medications can accumulate in the kidney
67
Q

3 Generics of Antacids

A

Aluminum Hydroxide, Calcium carbonate, Magnesium Hydroxide

68
Q

Brand name of Aluminum hydorxide

69
Q

Dosing of Aluminum hydroxide

A

2-4 tsp PO four times daily

70
Q

2 brand names of calcium carbonate

A

Tums, Maalox (tablets)

71
Q

Dosing of Tums (calcium carbonate)

A

1-2 tablets PO prn

72
Q

Dosing of Maalox tablets (calcium carbonate)

A

2-3 tablets PO prn

73
Q

Brand name of Magnesium hydroxide

A

Philips’ Milk of Magnesia

74
Q

Dosing of Magnesium hydroxide (Philips’ Milk of Magnesia)

A

depends on strength and dosage forms

75
Q

What might be beneficial for gas and bloating

A

products containing simethicone (Gas-X)

76
Q

Adverse effects of Antacids

A

Calcium&Aluminum : constipation
Magnesium : Diarrheal
Magnesium&aluminum : accumulation in renal patients
Belching/gas
Chalky taste

77
Q

MOA of Histamine 2 receptor antagonists

A

inhibits gastric acid secretion

78
Q

adverse effect of Histamine 2 receptor antagonists

A

abdominal discomfort, constipation, diarrhea

79
Q

onset of action of Histamine 2 receptor antagonists

80
Q

duration of action of Histamine 2 receptor antagonists

81
Q

Caution of Histamine 2 receptor antagonists

A

should take approximately 30-60 min before a meal

82
Q

3 drugs of Histamine 2 receptor antagonists

A

Famotidine(Pepcid AC) Cimetidine(Tagamet HB) Nizatidine(Axid AR)

83
Q

Brand name of Famotidine

84
Q

Dosing of Famotidine (Pepcid AC)

A

10-20mg PO bid

85
Q

Brand name of Cimetidine

A

Tagamet HB

86
Q

Dosing of Cimetidine (Tagamet HB)

A

200mg PO bid

87
Q

Caution of Cimetidine (Tagamet HB)

A

avoid due to drug interaction (recommend any of the other H2As)

88
Q

Brand name of Nizatidine

89
Q

Dosing of Nizatidine(Axid AR)

A

150 mg PO bid

90
Q

MOA of Proton pump inhibitors

A

decrease gastric acid by inhibiting proton pump(these actively secrete acid)

91
Q

Onset of action of proton pump inhibitors

92
Q

duration of action of PPI

93
Q

Notes of Proton pump inhibitor

A
  • better at treating reflux symptoms for patients with moderate to severe symptoms
  • These agents are usually used with frequent heartburn with symptoms 2+days per week
  • patients should only take medication for shortest duration possible (May 2010: FDA placed a warning on all PPls for the risk of hip, spine, and wrist fracture with long term use)
94
Q

3 drugs of Proton pump inhibitors

A

Omeprazole (Prilosec), Omeprazole with sodium bicarbonate (Zegerid) Lansoprazole (Prevacid)

95
Q

brand name of Omeprazole

96
Q

dosing of Omeprazole (Prilosec)

A

adult : 20 mg PO once daily

97
Q

Brand name of Omeprazole with sodium bicarbonate

98
Q

Brand name of Lansoprazole

99
Q

Dosing of Lansoprazole (Prevacid)

A

Adult : 15 mg PO only daily

100
Q

Cautions of Proton pump inhibitors

A
  • Take PPIs once daily for 14 days; can repeat after 4 months if needed
  • should be counseled to call their physician if symptoms worsen or persist form more than weeks
  • If on Plavix
101
Q

If on ____, patients should contact physician before starting due to possible decrease efficacy ___.

A

Plavix ( this is controversial as to whether it is clinically significant)

102
Q

If there is no improvement after 14 days for self care

A

Go to doctor

103
Q

What is Nausea

A

characterized by a person’s subjective feeling of a need to vomit

104
Q

Goals of treatment of Nausea

A
  • Provide symptomatic relief
  • identify and correct the underlying causes
  • prevent and correct complications
  • prevent future occurences
105
Q

Exclusions for self-treatment

A
  • severe vomiting
  • chronic medical conditions
  • abdominal pain/distension
  • blood in vomit
  • pregnancy
  • suspected dehydration
  • refer to physician if vomiting persists > 24-28 hrs
106
Q

1 Drug for Nausea

107
Q

What is Emetrol

A

Combination of sugar and phosphoric acid = sugar water

108
Q

Dosing of Emetrol

A

PO every 15 minutes up to 1 hour at a time
2-12 yrs : 1-3 tsp
>12 yrs : 2 tablespoons

109
Q

notes of emetrol

A

encourage patients to stay well hydrated if possible

110
Q

What is Allergic Contact Dermatitis

A

Contact dermatitis is an itchy rash caused by direct contact with a substance or an allergic reaction to it.

111
Q

Exclusions for self-treatment

A
  • Patient < 2 yrs of age
  • Rash persisting > 2 weeks
  • Swelling of body or rash extending > 25 % of body
  • Open, weeping lesions
  • involvement of eyes, eyelids, nose, mouth
112
Q

2 medications for Allergic contact dermatitis

A

Corticosteroids, Topical antifungals

113
Q

1 drug of Corticosteroids

A

Hydrocortisone 0.5-1%

114
Q

brand name of hydrocortisone 0.5%-1%

A

Cortizone-10

115
Q

What hydrocortisone is used for

A

to relieve itching, redness and rash from dry skin, insect bits, allergic reactions including poison ivy

116
Q

cautions of Corticosteroids (hydrocortisone(cortizone-10))

A
  • external use only
  • avoid contact around eyes and mouth
  • avoid use in children under 2 yrs of age
  • discontinue and consult MD if condition worsens or persists > 7 days
117
Q

Notes of Topical Antifugals

A
  • there are many a variety of products that cover many different fungal infections ( Athlete’s Foot, Jock Itch, Ring Worm, Vaginal Yeast Infection)
  • Pay attention to duration of treatment
118
Q

5 generics of Topical Antifugals

A

Miconazole cream, Clotrimazole cream, Terbinafine cream, Ketoconazole shampoo, Tolnaftate cream

119
Q

Brand name of Miconazole cream

120
Q

Brand name of Clotrimazole cream

A

Lotrimin AF

121
Q

Brand name of Terbinafine cream

122
Q

Brand name of Ketoconazole shampoo

123
Q

Brand name of Tolnaftate cream

OTC Exam (1 decks)

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